| ObjectiveEvaluation of 3 different kinds of intraocular lens tilt and decentration in the capsular bags after age-related cataract surgery based on a new anterior segment swept-source optical coherence tomography CASIA2.MethodsRetrospective case series.Clinical data of age-related cataract patients who underwent phacoemulsification and IOL implantation from October 2021 to March 2022 were continuously collected.The patients were implanted with A group(HOYA250),B group(RS60A),C group(ZCB00),respectively.Clinical data such as age,sex,best corrected visual acuity of pre-operation and the first day after surgery,axial length,type and power of IOL used were collected from all patients.CASIA2 post-op cataract model was applicated in obtaining clear images respectively at 1 day,7 day and 30 day postoperatively.Tilt and decentration at horizontal and vertical in 2D images,the tilt and decentration and their direction in 3D images were counted.Measurement data in accord with normal distribution data is expressed by mean±standard deviation,non-normal data is represented by P50(P25,P75),count data is expressed by frequency(percentage,%).Normality test and homogeneity test of variance were conducted for measurement data such as tilt and decentration in the capsular bags.If normal distribution was followed and homogeneity of variance was satisfied,one-way analysis of variance was used for inter-group comparison and single factor repeated measure analysis of variance was used for intra-group comparison.If measurement data did not conform to normal distribution or did not meet the homogeneity of variance,Kruskal-Wallis H test was used for inter-group comparison and generalized estimation equation is used for intra-group comparison.Count data were tested by fisher exact test.Significance was represented by P value,and P<0.05 was considered statistically significant.In order to avoid class I errors,pairwise comparison between groups was conducted for multiple tests and P<0.05,which was adjusted by Bonferroni correction method,was considered statistically significant.SPSS26.0 software was used for statistical analysis.P<0.05 was considered statistically significant.ResultsA total of 134 patients 157 eyes were enrolled.There were 52 males and 82 females,with an age from 45 to 86 and an average age of 67.86±8.256 years.The right eye was divided into A group,B group and C group with 31 eyes,34 eyes and 15 eyes,respectively.The left eye was divided into A group,B group and C group with 25 eyes,29 eyes and 23 eyes,respectively.There was no significant difference in age and ocular axial length among3 groups in right and left eyes.(P > 0.05).Right eyes results: At 7 day postoperatively,the horizontal tilt degree of A group-5.135±1.206°was bigger than B group-4.250(-5.250,-2.800)°in 2D images,At 1 day and 7 day postoperatively,the horizontal decentration of A group-0.059±0.102 mm,-0.077±0.117 mm were smaller than B group-0.200(-0.260,-0.060)mm,-0.146±0.189 mm in2D images,At the 1 day and 7 day postoperatively,the vertical tilt degree of A group-2.200(-2.500,-1.000)°,-1.787±1.089°were bigger than C group-0.547±1.636°,-0.813±1.385°in 2D images,there was significant difference between them all of the above(P<0.05).At 1 day and 7 day postoperatively,there were significant difference in orientation of tilt between A group 201.129±15.286°,199.161±10.795°and C group186.33±19.010°,188.867±17.582° in 3D images(P<0.05).The vertical decentration of A group after 1 day postoperatively 5.494±1.016 ° was bigger than the 30 day postoperatively 5.300(4.900,5.800),there was significant difference between them(P <0.05).At 1 day,7 day and 30 day postoperatively,the decentration of A group0.145±0.051 mm,0.150(0.100,0.190)mm,0.169±0.089 mm were smaller than B group0.241±0.116 mm,0.225(0.148,0.313)mm,0.285±0.157 mm in 3D images,there were significant difference between them(P<0.05).There were no significance in the rest intergroup results and intra-group results(P > 0.05).Left eyes results: At the 7 day and 30 day postoperatively,the decentration of A group0.132±0.067 mm,0.143±0.056 mm were smaller than B group 0.203±0.096 mm,0.217±0.104 mm in 3D images,there were significant difference between them(P<0.05).The tilt of C group after 1 day postoperatively 5.000(4.300,5.400)° was smaller than the 30 day postoperatively 5.139±1.069°,there was significant difference between them(P < 0.05).There were no significance in the rest inter-group results and intra-group results(P > 0.05).At 1day,7 day and 30 day postoperatively,three groups of IOL are leaning to temporal and infratemporal trend,the trend of the tilt showed no biased.The best corrected visual acuity of all groups were improved to different degrees on the first day after surgery,with no statistical significance(P > 0.05).Conclusion1.3 different IOLs included in the study,with the corneal topographic map axis as the reference line measured by CASAI2,within 1 month after surgery,there were different degrees of tilt and decentration of the 3 kinds of IOLs in the capsular bags after operation.2.Within one month after surgery,IOLs of the 3 groups showed a tendency to tilted to the temporal side and the infratemporal side,and the decentration did not show a tendency to bias. |
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